How to handle your child’s asthma

According to the Allergy Society of South Africa, asthma is one of the most common childhood diseases. In 2014 it affected up to 20% of South African children. Children who have parents with an allergic disease are much more likely to develop an allergic disease themselves and since asthma can be life threatening if not managed properly, we asked sister Sonja Sauer to share some ideas of how to manage your child’s asthma.

What is asthma?
Asthma affects the airways of the lungs. The airways are oversensitive and easily irritated by common triggers. The triggers cause swelling and narrowing of the airways and result in difficulty breathing.

When children are diagnosed with asthma, it doesn’t mean that they can’t live normal lives. It means that parents, caregivers and children should be aware of possible triggers and have an action plan in place to handle the symptoms that can lead to an asthma attack. Although asthma cannot be cured, the symptoms can be effectively controlled with correct treatment. 

Possible triggers in the environment
Asthma is triggered by various stimuli in the environment and each child reacts differently to these triggers. 

Triggers can include:

  • Airborne allergens such as pollen, animal dander, mould, dust mites and cockroaches
  • Respiratory infections such as common colds
  • Physical activity
  • Cold air
  • Air pollutants and irritants such as cigarette smoke 
  • Certain medications including aspirin and ibuprofen
  • Strong emotions and stress
  • Sulphites and preservatives added to some types of foods and beverages
  • Gastro-oesophageal reflux disease, a condition in which stomach acids back up into your throat

You might want to read about allergies and food intolerance.

What does an asthma attack look like?
During the asthma attack, the lining of the airways becomes swollen or inflamed and thicker mucus is produced. All of these factors cause symptoms of an asthma attack such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. 

Other symptoms of an asthma attack may include:

  • Severe wheezing when breathing both in and out
  • Coughing that won't stop
  • Very rapid breathing
  • Chest tightness or pressure
  • Tightened neck and chest muscles
  • Difficulty talking
  • Feelings of anxiety or panic
  • Pale, sweaty face
  • Blue lips or fingernails
  • Worsening symptoms despite use of medication

What to do when a child gets asthma attack?
An individualised asthma action plan should enable a parent, teacher or caregiver to medicate and manage the symptoms of an asthma attack. 

If a child does not have an existing action plan for asthma and gets an asthma attack while in your care, you should:

  • Notify the child’s Health Care Provider immediately:
  • Follow the directions as given to you by the Health Care Provider 

Give quick relief medicine if the child has an inhaler or use an inhaler from a first aid kit if available:

  • Sit child upright
  • Loosen tight clothing
  • Give one puff from inhaler into spacer
  • Ask child to take four breaths from spacer
  • Repeat ‘puffs and breaths’ steps four times
  • Wait four minutes. If there is no improvement give another four puffs.

Follow up:
The emergency room doctor will check the severity of the attack and provide treatment that includes medication 
Child may be discharged or hospitalised depending on the response to treatment
If the symptoms do not quickly improve after following the asthma action plan, contact your emergency medical service right away. 

Immediate medical attention is required if the child:

Is having a hard time breathing
Constantly coughing
Unable to talk, eat or play
Turning blue in the lips or fingers
Convulsing while breathing (using stomach muscles excessively to breathe)
Possible treatment options for asthma
Many parents are worried about giving their children medication every day, especially because of potential side effects. Uncontrolled asthma can be very dangerous.  Asthma medication is in fact very safe if prescribed correctly and at the right doses.

Treatment of asthma is usually in the form of asthma pumps called inhalers. There are two types of inhalers:

  • Controllers controls asthma symptoms by preventing the inflammation and swelling in the lungs caused by triggers, so that they don’t occur in the first place
  • Relievers are rescue pumps that should only be used in case of an emergency. They act quickly to open airways. If your asthma is well controlled, you should not need to use the reliever pumps. 
Children should use a chamber called a spacer device when using a pump to ensure the medication gets to the lungs effectively and not to the rest of the body or back of the throat.

In some cases, inhalers are not enough to control symptoms then other medication such as tablets may be needed in addition to the pumps.

Can my child still participate in sport when they have asthma?
If well controlled, children with asthma should lead a normal life, free of symptoms, attend school regularly and participate in activities, including sports. They should be able to sleep restfully and grow and develop normally. 

Who to inform that your child has asthma

  • Caregivers that look after your child
  • Your child’s teacher
  • Your child’s sport coach
  • The parents of friends your child visit

Teach your child about asthma, the triggers they are sensitive to, and how to help themselves or seek help in the case of an asthma attack. Even at a very young age they should understand what is happening to them and that it can be controlled.

Asthma resources
The Environmental Protection Agency offers a variety of free asthma publications. One is called “Dusty the Asthma Goldfish and his Asthma Triggers Funbook�?. This is a fun way to teach your child about asthma.

You can download this educational tool from: